How Charting Your Cycle can Help Diagnose Endometriosis

Endometriosis is a complex condition that usually goes undiagnosed. Rarely able to be diagnosed without a small surgery being involved, it is often overlooked as a cause of health problems or dysfunction.

There is no blood test or simple imaging scan that can diagnose endometriosis. In studies, 20% of women who were ultimately diagnosed with endometriosis reported no menstrual cramps, and another 40% reported only mild or moderate menstrual cramps. Also, most women who end up diagnosed with endometriosis have fairly normal length cycles, having periods about every 28-32 days.

Just because a doctor can’t find it or see it, that doesn’t mean that it isn’t there, causing infertility, cycle problems, or painful periods.

A quick anatomy lesson to help us understand what is going on in the case of a woman with endometriosis. A woman’s uterus, or womb, has an interior lining called the endometrium. It is this lining that thickens in preparation for possible pregnancy and then sheds when pregnancy doesn’t occur and that lining is no longer needed. Sometimes these tissues that should be inside the endometrium end up outside of it-usually in other locations in the pelvic cavity like above the ovaries, on the colon, on the bladder, or really anywhere in the pelvic cavity. More rarely, the endometrial implants have even been found in the lungs and liver. This is endometriosis. These tissues respond to normal hormone changes happening during a woman’s cycle, bleeding when you’re menstruating. This can cause inflammation and scar tissue to develop.

So, why can’t a doctor usually see endometriosis using something like ultrasound? Think of the ultrasounds you’ve seen of babies. Can you make out distinct facial features? Hair color? Birthmarks? No, of course not. Even with ultrasounds becoming better and better, most of the smaller details are not able to be seen until we actually meet the baby. Endometriosis is similar. It’s often small deposits that, when seen with the naked eye, look like darker parts of the normal tissues. Often they are deeply imbedded, making them even harder to see.

When a woman starts charting with the Creighton Model, there are certain signs, or biomarkers, on her chart that can indicate that she may have endometriosis. Prior to beginning charting, she may not have even realized that she had these signs, or that they might indicate endometriosis.

Here are some signs that I look for:
#1. A limited amount of cervical mucus, or no cervical mucus at all. With our system, we actually have ways to calculate and classify a woman’s cervical mucus. Without getting too deep into more biology lessons, a healthy amount and number of days of cervical mucus is an indicator that a woman’s ovaries and cervix are functioning properly. Without good cervical mucus, it is very difficult for pregnancy to occur, as it is mucus that transports sperm to the egg inside the woman’s body.

#2. Very heavy periods. Now, you might be saying, “I don’t have very heavy periods.” Something to consider is that the only period you’ve ever seen is your own. Do you talk to your girlfriends about how often they change their pads or tampons to see if your period is normal? I don’t, and I talk about this stuff every day. When we teach women to chart, we teach her exactly what level of flow she should call “very heavy, heavy, medium, or light.” Most of the time the woman just calls her heaviest day, “Heavy,” but when compared with a population of women, what she might actually be having is very heavy, or possibly even light. I did work with a woman who had no idea that she never had more than a light menstrual flow, though she had initially labeled her heaviest day as “Heavy.” We help women see if their menstrual flows are actually normal when compared to other women.

#3. Pre-menstrual spotting. Periods should be kind of like faucets. They should turn on and then turn off. Having multiple days of brown or very light spotting prior to your period really “getting going,” is associated with a host of fertility health problems, including endometriosis.

If you suspect that you have endometriosis and you’d like to learn how the Creighton Model can help you, please email me at . I’d love to talk to you.


The Medical & Surgical Practice of NaPro Technology by Dr. Thomas Hilgers, M.D.


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